Wednesday , December 2 2020

88% of UK children who had undergone tonsillectomy had no need for them – Quartz



Every year, hundreds of small children in the United Kingdom do not need surgery.

This is the result of a recent study in the English Journal of General Practice conducted by a group of researchers at the University of Birmingham. The study found that between 2005 and 2016, 88.3% of children who underwent tonsillectomy in the UK did not meet the medical threshold for the procedure and could not benefit from it.

Tonsillectomy is not without risk.

Under the medical rules known as Paradise Criteria, American Ear Nose Throat Academy and other important medical associations, at least seven sore throats in the last year, if there are at least five sore throats in the last two years, only tonsillectomy is recommended for children. or at least three sore throats in each of the previous three years. However, most childhood tonsillectomy in the United Kingdom in recent years has been performed on children who do not meet these criteria.

Researchers from the University of Birmingham came to this conclusion after analyzing the medical records of 1.6 million children from more than 700 United Kingdom general practice in the country's Health Improvement Network (THIN) between 2005 and 2016. In this period, only 2,144 (11.7%) had sufficient sore throat to justify the operation.

This is alarming – although tonsillectomy for children is widespread – surgery comes with risks of complications. According to a case study of Canadian health administrative data used by Birmingham researchers, 2.7% of children who received tonsillectomy go to the emergency room within 30 days, with 12.4%. A review in 2014 pediatrics The United States reported that 7.8% of children who had undergone tonsillectomy were hospitalized with complications within 30 days. And another study showed that the most common causes of admission are excessive bleeding, acute pain, fever, vomiting and dehydration.

Even when children accept the procedure, parents may want to consider the & careful waiting York strategy according to Nicholas Balakar in the New York Times. The reason for this is that a recent study of more than 60,000 Danish children, with tonsillectomy considered useful for severely affected children, showed that the procedure was associated with a much higher risk of upper respiratory tract diseases.

Unnecessary surgery risks for children

Tragic, but rare cases have stressed the importance of ensuring that children perform only the operations they need, such as the death of Jahi McMath, 13, after a tonsillectomy in 2013. According to Pacific Standard Magazine, alel Every year in America, thousands of children die from suspected medical interventions and poor follow-up. Pacific

Unnecessary surgical procedures also represent a burden on public health systems: for example, the National Health Service (NHS) in the United Kingdom carried out a total of 37,000 children's tonsillectomy from April 2016 to March 2017 and 42 million pounds spent.

The Birmingham study acknowledged that the National Health Service analysis was correct, but clarified that digital medical records always reflect why a tonsillectomy is recommended. This meant that there may be other reasons why doctors chose to continue surgery in a certain way. cases.

Tom Marshall, a study author and professor of public health at Birmingham University, says his team has made higher estimates, since they use a broad definition of tonsillitis rather than anticipating the number of children with sore throat before surgery. or sore throat caused by infected tonsils. However, even after conducting the analysis with a more stringent definition of sore throat, the researchers said that tan the majority of children with frequent sore throat are still unable to remove their tonsils Bun.

Birmingham researchers in England did meet the criteria of tonsillectomy and had seven or more severe sore throats in a year, only 14% actually received surgery. Marshall said he was wondering if it would "hurt the children more than help with tonsillectomy."

”We noticed that even among the children who were severely affected, there were only tons of tonsils,“ he said. Tons Wonder if you have tonsillectomy [is] really important for every child. "


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